News | November 16, 2011

Non-Adherence to Antiplatelet Therapy Following PCI Results in More Ischemic, Bleeding Events

November 16, 2011 — Non-adherence to antiplatelet therapy – which prevents blood clots following percutaneous coronary intervention (PCI) – was associated with higher rates of both ischemic and bleeding events at 30 days. Results of the PARIS registry were presented at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation.

Dual antiplatelet therapy (DAPT) with aspirin and a thienopyridine is the cornerstone of treatment for patients presenting with acute coronary syndromes and for patients undergoing PCI with stents. Current guidelines recommend at least one year of DAPT for all patients following PCI with a drug-eluting stent (DES), and 30 days after a bare metal stent.

Premature discontinuation of DAPT (within the first six months after implantation of DES) has been associated with an increased risk of stent thrombosis. The optimal duration of DAPT has not yet been precisely determined, especially with regard to second generation stents.

The PARIS Registry (Patterns of Non-Adherence to Anti-Platelet Regimens In Stented Patients: An Observational Single Arm Study) is a multi-center, multinational, observational study with an “all comers” design. The study will follow 5,033 subjects for approximately 24 months post stent implantation (bare metal and drug-eluting stents).

The objectives of this study are to examine modes of non-adherence to DAPT in patients following stenting, and to evaluate subsequent clinical outcomes and their relation to non-adherence.

The incidence of non-adherence to DAPT in this “real world” international observational registry was 2 percent at 30-day follow-up.

In the non-adherent population at 30-days:

  • 69 percent had disruption of therapy - mostly due to noncompliance (61 percent) and bleeding event (32 percent)
  • 19 percent had interruption of DAPT - mostly due to surgery or medical procedures (67 percent)
  • 12 percent had discontinuation of therapy (recommended by physician)

“Importantly, any non-adherence (aspirin or thienopyridine – non-adherence was equally distributed) was associated with higher rates of both ischemic and bleeding events at 30 days including death, myocardial infarction, definite and/or probable stent thrombosis, target vessel revascularization, and bleeding (BARC?3),” said Roxana Mehran, M.D., the co-principal investigator of the study. Mehran is professor of medicine at Mount Sinai School of Medicine and director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute. She also serves as chief scientific officer of the CRF Clinical Trials Center.

“There was a six-fold increase in odds for definite or probable stent thrombosis associated with non-adherence compared to adherence to DAPT at 30 days. The two year data will be more definitive and should be able to link the patterns of non-adherence with important clinical events,” Mehran said.

The PARIS trial is sponsored by Mount Sinai School of Medicine with grant support from Sanofi-Aventis and Bristol-Myers Squibb. Mehran reported no other financial support from the companies except for the research grant.

For more information: www.crf.org

Related Content

News | Cardiovascular Surgery

November 23, 2021 — A novel device called venous external support (VEST) may lead to increased longevity and durability ...

Home November 23, 2021
Home
News | Cardiovascular Surgery

November 22, 2021 — The Minneapolis Heart Institute Foundation (MHIF) announced the publication of research showing ...

Home November 22, 2021
Home
News | Cardiovascular Surgery

November 18, 2021 — Moderna Inc. announced positive data from the AstraZeneca-led Phase 2 (EPICCURE) study evaluating ...

Home November 18, 2021
Home
News | Cardiovascular Surgery

November 18, 2021 — People who are on the antiplatelet medication ticagrelor and need coronary artery bypass surgery may ...

Home November 18, 2021
Home
Feature | Cardiovascular Surgery | By Noam Emanuel, Ph.D.

Surgical Site Infection (SSI) prevention remains a high priority for cardiac surgeons whose heroic efforts can be ...

Home June 24, 2021
Home
News | Cardiovascular Surgery

April 5, 2021 — Smidt Heart Institute transplant surgeons Dominic Emerson, M.D., and Pedro Catarino, M.D. know how to be ...

Home April 05, 2021
Home
News | Cardiovascular Surgery

March 30, 2020 — Patients undergoing coronary bypass graft (CAGB) surgery lived longer and had better outcomes when ...

Home March 30, 2020
Home
News | Cardiovascular Surgery

February 27, 2020 — The U.S. Food and Drug Administration (FDA) sent a safety communication this week to healthcare to ...

Home February 27, 2020
Home
News | Cardiovascular Surgery

October 23, 2019 — Proactive administration of amiodarone to patients recovering from a common heart surgery shows ...

Home October 23, 2019
Home
News | Cardiovascular Surgery

October 17, 2019 — W. L. Gore & Associates Inc. will support a new Society for Vascular Surgery (SVS) initiative to ...

Home October 17, 2019
Home
Subscribe Now